PB2597: EVALUATION OF PEDIATRIC TRANSFUSION PRACTISES IN A TERTIARY CARE HOSPITAL
Authors: Tunç Aydin, Özlem Tüfekçi, Şebnem Yilmaz, Hale Ören
Journal: HemaSphere (2023)

Topic: 31. Transfusion medicine Background: Blood product transfusion is one of the important supportive treatments that is frequently used in clinical practice and is life-saving when appropriate. Indications and transfusion practises vary considerably among physicians, specialities (internal and surgical) and centers, in addition to the patient-related factors. Aims: We aimed to analyze the transfusion practices including indciations, pre-transfusion threshold values and complications according to the underlying diseases and specialities (internal and surgical) in pediatric patients other than pediatric hematology-oncology and intensive care unit patients. Methods: This retrospective study included pediatric transfusion practises including erythrocyte suspension, platelet suspension, and fresh frozen plasma in children between 0-18 years of age, that were hospitalized in various inpatient clinics in our hospital between February 2018 and January 2020. Patients with hematologic-oncologic disease and those who were hospitalized in pediatric intensive care units were excluded. Results: A total of 922 transfusions were administered to 454 patients and of all the transfusions; 61.7% (569/922) were erythrocyte, 33.1% (305/922) were fresh frozen plasma, and 5.2% (48/922) were platelet suspension. A total of 65% of the patients received blood products for surgical reasons; 23.3% of whom were due to congenital cardiac anomaly, 20.5% of them were due to orthopedic diseases, 16.7% were due to multiple trauma, and 4.6% were due to acute abdominal surgery. Mean and median pre-transfusion Hb in internal clinics (pediatrics and pediatric emergency) was 7.2 ± 1.2 (2.2-12.8) g/dL and 7.3 (6.6 -7.8) g/dL, respectively while mean and median pre-transfusion Hb in surgical clinics (pediatric surgery, pediatric cardiovascular surgery, pediatric orthopedics) was 8.3 ± 1.8 (3.5-16) g/d and 7.9 (7.3-8.9) g/dL, respectively. Pre-transfusion Hb values was found to be significantly higher in surgical clinics (p<0.001). Mean and median pre-transfusion platelet count in internal clinics was 40.3 ± 47 (7-252) x103/mm3 and 23 ± 1.2 (15-46) x103/mm3, respectively while mean and median pre-transfusion platelet count in surgical clinics was 81.3 ± 66.5 (17-187) x103/mm3 and 49.5 (38-151.7) x103/mm3, respectively. Pre-transfusion platelet count was found to be significantly higher in surgical clinics (p=0.044). The frequency of transfusion reactions was noted as 0.6% in all transfusions. Summary/Conclusion: The results of our study indicated that transfusion practices vary significantly in pediatric patients according to underlying disease and specialities. It was observed that surgical clinics had higher transfusion thresholds and wider indications compared to internal clinics, which might be due to clinical prediction as well as general ongoing attitudes of the physicians in that speciality. The adoption of the concept of patient blood management and the application of its principles will ensure the appropriate, timely and correct use of blood products and contribute to the standardization of transfusion practices. Keywords: Hemoglobin, Platelet, Fresh frozen plasma, Blood transfusion